Why Isn't Obama Doing Anything About Congress? Can He?

After ending on a cynical note in my last post----mentioning my uncomfortable suspicion that the Obama administration, Dems and Republicans, right along with the insurance companies, would like nothing more than to mandate that everybody buy insurance (expanding the market by 50 million), while doing next to nothing to bring down premiums, which would require de-consolidating the industry with a "public option" competitor----I felt slightly guilty.

Well...that was until I read the L.A. Times, which reports that expert analysts are saying that while it's true that there are many bills in circulation right now, many leading proposals have insurers "poised to reap a financial windfall."

The half-dozen leading overhaul proposals circulating in Congress would require all citizens to have health insurance, which would guarantee insurers tens of millions of new customers -- many of whom would get government subsidies to help pay the companies' premiums.

So, the public must continue paying for not only the skyrocketing premiums, which analysts say will double by 2010, but also increased subsidies (tax money that could no doubt be better spent) that go straight back to these providers so they can, in turn, support their ludicrously high prices. Does a guaranteed expansion of the health care market by tens of millions of customers and essentially government-supported consolidation through subsidies without a mechanism for ensuring competition sound like a good deal? Is that really reform? We might also ask ourselves: How much have these premiums been rising the past six years? Answer: "by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent." No competition. The government will just help pay the exorbitant health care premiums, though the percentage of cost covered is going to drop (should the industry get its way). Sounds like a perverted form of corporate protectionism. Hardly the government intervening to fix an oppressive market failure.

In fact, we could have the opposite: The Senate Finance Committee has been playing around with the idea of requiring insurers to reimburse customers for at least 76% of their medical costs, though that number has now dropped to around 65%. The current percentage that insurers cover is 80-90%, and yet the industry is still arguing for the "government [to] set the floor lower so insurers could provide flexible, more affordable plans." As a consumer, why would I want a health care "reform"bill that actually lowers the percentage of costs they're obligated to pay? Doesn't really sound like an improvement, seeing as how under the current system 50% of bankruptcies are medical related, and 75% of those filing for bankruptcy had private insurance when they filed. This haggling---whatever the result---won't help solve the problem at all, unless of course health insurance covered practically all the costs.

The question remains then: Why hasn't Obama used the bully pulpit to urge Congress in the right direction? Some have argued, like Matt Yglesias, that the president can't control Congress, which is of course very true. Although, as Glenn Greenwald points out: (1) "the President commands a vast infrastructure on which incumbent members of Congress rely for re-election." He cites Rahm Emanuel's ability to whip up votes in the past. And (2) The "Obama White House has proven itself extremely adept at compelling compliance with the President's agenda" when it came to pushing non-compliant progressives into supporting the war supplemental bill.

The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday.

Though Greenwald acknowledges that Obama can't "single-handedly control what Congress does," he notes the disparity of leverage he exerts, on the one hand "protecting" Blue Dog "centrists," while on the other, holding progressives to a different standard. And Republicans still call this guy a "leftist" and a "liberal." One thing I find extremely disconcerting about all of this, if Greenwald's correct, is that

Blue Dogs -- virtually all of whom represent more conservative districts -- are more vulnerable and thus more dependent for re-election on the White House and Democratic Party infrastructure than progressives are.

As far as the whole "bipartisan" excuse for watering down the health care bill, Greenwald is right to point out the obvious: that the GOP was not and is not interested in passing any bill, whatever its form. That has been understood from the outset: "Senate Minority Whip Jon Kyl (R-Ariz.) announced that Republicans will reject reform no matter what's in the bill." It makes sense that they'd try and obstruct Obama's agenda regardless of the details. Why would they be interested in passing reform?

Why would the GOP want to help Obama achieve one of his most important and politically profitable goals? Of course they were going to try to sabotage the entire project and would oppose health care reform no matter what form it took.

And now that closed-door meetings with the pharmaceutical industry have been reported, "a deal to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion"despite Obama's pledge to have all wheeling and dealing broadcasted on CNN (like that would ever happen)---how could the purported necessity for a "bipartisan" bill---with all the attendant, illogical excuses for the lack of a more economically practical, progressive bill----not appear like a pretext for a watered-down, industry-friendly piece of legislation?

With the quiet agreement between the White House and industry restricting savings to no more than $80 billion, compare the Urban Institute's study on public policy, which estimates "that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people." That is a huge concession to private industry. No wonder they're keeping the meetings closed. Industry is in no hurry to allow substantial reform, and Democrats have only been at this since Roosevelt, so why not make it another 75 years? What's the rush? (See Bill Moyers on the heart wrenching, human cost of the current system here, and media research on the historical efforts to stop health care reform over the past 75 years here).

Everybody knows that Democrats have a super-majority. But need we be reminded that they could pass legislation, like the Republicans did with the Bush tax cuts, with only a simple majority----if they wanted to. Instead, we get more excuses, just as we did back when they were in the minority:

During the early Bush years, the excuse was that they endorsed Bush policies because his popularity and post-9/11 hysteria made it politically unwise to oppose him. In later Bush years when his popularity plummeted, the excuse was that Democrats were in the minority and could do nothing. After 2006 when they won a Congressional majority, the excuse was that Bush still controlled the White House and had veto power. After 2008 when a Democrat won the White House, the excuse was that Republicans could filibuster.

Now that they have a filibuster-proof majority, a huge margin in the House and the White House, the excuses continue unabated, as Democrats are now on the verge of jettisoning one of the most significant attractions for progressives to the Obama campaign -- active government involvement in the health insurance market.

Compounding the disillusionment triggered by the apparently inevitable, Democratic betrayal on this pivotal issue is the fact that the administration dropped the truly progressive agenda before even coming to the table: a single-payer, universal health care plan. In its absence, progressives were placated with a proposed "public option," which now looks to be dead unless the House grows a pair, or Obama retrieves his soul.

How Obama feels about the apparent loss of a public plan is unknowable for sure. But actions do matter, regardless of one's oratorical eloquence, and the bill that's most likely to make it through Congress does have some powerful supporters:

...the pharmaceutical industry is so delighted with what they think will be the ultimate plan that they are spending vast sums of money to advocate for it.

Also factor in

a secret White House deal with that same industry to ensure there are no government negotiations for better prices (a result that, when combined with mandates to buy health insurance, would vastly increase the profits of these industries)

And...with a White House Deputy Chief of Staff (and "Small-State" westerner), Jim Messina, ---who was formerly Chief of Staff to Senator Max Baucus, head of the disproportionately influential, anti-progressive Table of Six----working under the corporate-approved, Chief of Staff, Rahm Emanuel, it seems more than plausible that Obama has been appropriated by anti-progressive forces.

Even take Tom Daschle, who, forced to withdraw his nomination as head of Health and Human Services because of $140,000 in unpaid back taxes, is serving as an informal advisor to Obama, despite the clear conflicts of interest: Since losing re-election in 2004, Daschle's clients have been those same private health insurance companies the government is ostensibly seeking to regulate.

...he remains a highly paid policy adviser to hospital, drug, pharmaceutical and other health care industry clients of Alston & Bird, the law and lobbying firm.

But don't worry because "Friends and associates of Mr. Daschle say the interests of Alston & Bird’s clients have no influence on his views," even though critics say he's "advocating the very policy which his industry clients want: namely, health care reform with mandates, but no 'public option' -- only with 'co-ops.'" According to the NYT, Daschle has been the main force behind selling "co-ops," a tepid measure that the Democrats and Obama are evidently finding very palatable these days. But then again, we'll just have to wait and see. Maybe progressive forces can push him back on a sustainable track, if they're loud enough.

If not, we can always revert to the early nostalgia phase, when Obama was pretending to be a "liberal" or "progressive," which among other things, currently means one who believes in, and carries out a commitment to transparency and public participation.

And don't miss this useful chart for understanding health care reform.

Note: Even Robert Reich is asking about the disproportionate and inappropriate power of the Table of Six, "Why has it come down to these six? Who anointed them? Apparently, the White House." He doesn't "get it" either:

I really don't get it. We have a Democratic president in the White House. Democrats control sixty votes in the Senate, enough to overcome a filibuster. It is possible to pass health care legislation through the Senate with 51 votes (that's what George W. Bush did with his tax cut plan). Democrats control the House. The Speaker of the House, Nancy Pelosi, is a tough lady. She has said there will be no health care reform bill without a public option...So why does the fate of health care rest in Grassley's hands?

Let's hope the administration is still susceptible to hearing those beyond the private-interest forces that have invested it.

Who Said the Public Option Was Vital?

If I were conspiratorially-minded, I might think the Obama administration is trying to lose the public option (Personally, I think it's less "conspiracy" than the corporatist confluence in government thesis, not the "revolving door" so much as the "corporate archway" that Naomi Klein describes in Ch. 15 of The Shock Doctrine). Many are wondering why he's positioning to turn his back on progressives, who incidentally, take the same position that 72% of Americans do: That there should be a public option to compete with private insurance----which, by the way, has highly consolidated 94% of health care markets . Strangely, most media are reporting this apparent shift as simply a possible betrayal to progressives, and not to the majority of Americans. That's because media like to talk about the "Left" or "Far Left" as The Other. This constitutes "centrism" and "objectivity" by their standards.

But returning to Obama losing substantive health care reform, Ari Berman of The Nation asks, "...how, exactly, was Obama's landslide victory [67 million votes] a mandate for Baucus and Grassley [1,347,000 votes combined] to hijack the president's agenda?"

Good question. And what was/is Obama thinking in trusting Baucus? This is a man who voted with Bush for Medicare privatization and massive tax cuts. On the committee, he even demonstrates an unusual amount of deference towards his supposed counterpart, Sen. Grassley.

Well, over the weekend, Obama and Health and Human Services Secretary Kathleen Sebelius started sending the message that the public option is "'not the essential element'" of the administration's health care overhaul." In other words: prepare to be let down, humble majority. Yet in fairness, I should say that in characteristically spineless, Democratic fashion, the White House has since triangulated away from these startling admissions----so who really knows? Still, "not the essential element" is not what Obama was saying while campaigning. It was quite the opposite. And only a month ago, he said reform "must" include a public option. At least many in the House are standing up to this seeming betrayal, with some even threatening to vote against the bill if the public option is left out. Let's hope they keep up the pressure!



*My cynical, haunting suspicion is that both political parties and the insurance companies would like nothing more than to make it mandatory for us all to have (buy) medical insurance----but not do anything (or very little) for those who can't afford it. Already, many of us with insurance can't afford it. For example, the large corporation under whose plan my wife and I are covered is already announcing higher premiums for next year: We'll be paying over $500 a month for the two of us, when we have serious problems making ends meet as it is. Talk about liberty...

**As a side note: If Republicans ever want to stop pretending to look out for and actually start to care about the elderly, maybe they should focus on a problem that actually exists, like this one.

***Lastly: Seeing that Jon Stewart will be interviewing Betsy McCoughey on Thursday, he ought to start preparing by reading this article.

Now, Why Would He Say That?

Apropos to the last post and the anti-democratic structural problems with the over-representation of "Small States" in the Senate, and their senators, who, conveniently happen to lead in corporate PAC-money and dominate the main committee responsible for health care reform legislation, the Table for Six-----we now see one of its members, Sen. Chuck Grassley, endorsing the private-insurance-lobby-created-myth about government "death panels"(Good pieces on the lie's primary author, Betsy McCaughey of the Hudson Institute, and her history of lying here, here, and here). Surprising? Just how surprising, we'll see below. But again, I think Nate Silver's analysis goes a long way in explaining the appropriate context for understanding how and why this kind of brazen disinformation would be coming from one of the committee's members.



Grassley's comments are extremely interesting considering that in the past Republicans have supported Medicare reimbursements for "voluntary counseling sessions for end-of-life decisions." Sadly, there should be no confusion about this for Mr. Grassley. The supposed "death panel" provision, introduced in the House of Representatives by Rep. Earl Blumenauer (D-Ore.), has recently been co-sponsored by two others in his very own party: Rep. Charles Boustany (R-La.) and Rep. Patrick Tiberi (R-Ohio). And in his own Senate, Democrat Jay Rockefeller (W.V.) has a bill that also includes provisions for end-of-life counseling, also co-sponsored by a Republican, Senator Susan Collins (Maine). A similar bill waaaaay back in 2007 also had two Republican co-sponsors along with Collins----Richard Lugar, (R-Ind.) and John Isakson, (R-Ga.). Isakson even recently told the Post

How someone could take an end of life directive or a living will as that ["death panel"] is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

While Silver's analysis does shed some light on the structural reasons that might explain Grassley's shenanigans, there are more immediate causes. One of the anti-health reform groups behind loads of this mis/disinformation, Coalition to Protect Patients’ Rights, is managed by DCI, a lobbying firm formed in 1996 by a former staffer of Sen. Grassley's, Tom Synhorst (with help from Bob Dole, and right-wing operatives, Doug Goodyear and Tim Hyde). According to Think Progress, DCI's other public relations/"grassroots" accomplishments include:

1. The DCI Group was retained by the pharmaceutical industry to whip up public opposition against House legislation that would permit the reimportation of FDA approved drugs from Canada and elsewhere [free-markets, right?]. [Washington Monthly,December/2003]

2. The DCI Group worked with Republicans to form various “grassroots” front groups to amplify President Bush’s call to privatize Social Security. [Center for Media and Democracy, 3/18/05]

3. Chris LaCivita, a former DCI Group staffer, took a lead role in organizing the Swift Boat Veterans campaign to smear John Kerry and his war record. [CommonDreams, 8/31/04]

4. The DCI Group was behind spoof videos mocking Al Gore and global warming. The firm has been retained by ExxonMobil to lobby. [Wall Street Journal, 8/3/06; Exxon Secrets, accessed 7/28/09

One shouldn't think too hard on Grassley's motivations, I guess, but does it not seem eminently inappropriate for him to sit on the most important committee for deciding the fate of health care reform?

And going back to Silver: If he's right that corporate PACs target small-state senators, for all the reasons mentioned in the last post, we would see things like this: Insurance Industry Is Targeting Blue Dogs To Shape Health Reform In Its Favor.

So far $52 million has been spent on health care ads: $23 million spent on ads vaguely supporting "reform," and $29 million from the opposition. Yet, Ken Johnson of PhRMA knows where best to invest:

Most of it will come in targeted congressional districts where our companies have a significant economic presence, or in districts where members [of Congress] can still be persuaded to support comprehensive health-care reform.

Read: Blue Dogs from "Small States," with "comprehensive health-care reform" meaning barely any reform at all.

Of course, small-state senators aren't the only ones being targeted, though only one is apparently saying he'll kill reform because of all the liberal ads attacking him. After running television spots in Arkansas, Nevada and North Dakota last month, the Republican National Committee is going after "60 congressional districts in 33 states" and running ads "in the districts of four Blue Dog Democrats: Reps. Zack Space (Ohio), Baron P. Hill (Ind.), Bart Gordon (Tenn.) and Mike Ross (Ark.)." As a result, we should see a lot more ads like this one claiming that the health care reform bill will pay for abortions while denying legitimate procedures to the elderly. And we all know in which states they'll be running.

Anyways, in spite of all the irrational and irresponsible behavior surrounding the health care "debate," at least there's irony like this for supporters of substantial health care reform to discuss at the water cooler: an anti-health reform activist injured at a town hall meeting now seeking donations for his injuries. You see, he's lost his job, and hasn't got any insurance. Or maybe we can sit back and laugh while being scared to death by people like this guy:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Apparently, he agrees with Grassley that there is something to fear. Where could all this be coming from?

What Madison, Private Interests, And Small-State Senators Have To Do With Health Care Reform

Most people know that "Small States" are over-represented in the Senate, which has an extremely anti-democratic effect on our representative system of government. But according to Nate Silver, statistical genius at FiveThirtyEight,

A voter in Wyoming -- population 533,000 -- has about 70 times more ability to influence the Senate's direction than one in California -- population 36.8 million.

This is no surprise to those of us who remember high-school history because it was a major point for those who argued for the New Jersey Plan ("Small State Plan") over the Virginia Plan ("Large State Plan") when delegates were debating the Constitution: "Small States" could make up for lack of representation in the House, due to their smaller populations, by gaining equal representation in the Senate, or Upper House. However today, after 200+ years of the supposed "democratization" of our constitutional system, it looks---because it is!----strikingly unbalanced and anachronistic. Silver's article drives this home by illustrating how much more power "Small States" have when legislation---like health care----gets down to the committee level. Hopefully, you've taken the requisite amount of anti-depression drugs to swallow this.



The Table for Six, headed by Max Baucus, "is made up of members who collectively represent about 6.5 million people, or around one-fiftieth of the country's population," and yet their decisions will disproportionately influence the rest of us (the other 98%). That worry (the subject of the last post) that some of us feel about the gap between what The People overwhelmingly want in a health care reform bill (a public option to compete with the private plans), and what our legislators will most likely give us (a watered-down, pro-private insurance bill) is well justified. This is because "there is a correlation between the size of a state and how Democratic it tends to vote in elections for national office," though, of course, there are a few exceptions. And guess whose at the Table for Six? All small-state senators. But the most compelling point that Silver makes about this "structural problem" is in "the ways that small-state senators raise funds, and in turn, whose interests they are beholden to."



The Center for Responsive Politics has a chart illustrating "the highest percentage of their [senators'] campaign contributions since 2003 from corporate PACs." And who tops the list? Who are the top 10? All Republicans, except two (#7 and #8) with percentages ranging from 76.5% to 43.4%. But all of the Top 20 "come from states with below-median populations." Obviously, it's easier to get more campaign contributions from individuals in large states, so small-state senators do have a disadvantage in fundraising more non-PAC money. But PACs can----and indeed do----get a good deal on their money by targeting senators of smaller states. Silver draws some important conclusions from this structural deficiency:

What this means is that senators from small states tend to be relatively more dependant on special-interest money -- it makes up a larger share of their overall take. Senators from the ten smallest states have received, on average, 28.4 percent of their campaign funds from corporate PACs, versus 13.7 for those in the ten largest...senators from small states in fact have more incentive to placate special interests.

And how about those, like Baucus, at the Table for Six?

the six senators on Baucus's mini-committee are especially egregious in this regard. They rank #1 (Mike Enzi), #6 (Chuck Grassley), #11 (Kent Conrad), #13 (Baucus), #14 (Jeff Bingaman) and #20 (Olympia Snowe) in the share of contributions received from corporate PACs (an average of 47.5 percent of their funds overall).

Silver offers a couple suggestions to remedy the problem: restricting corporations from donating PAC money, unless they operate in the state; and, making the Internet a main instrument for donations to more populist-minded candidates. He also says that this small-state structural problem in the Senate helps explain why it "tends to be more protective than the House of corporate interests." He offers tax breaks and the second bank bailout as evidence of this (74% Senate, 60% of House approved the last bailout).



Structural problems indeed! And yet, our Madisonian constitutional system was set up to do just that: protect private, monied interests against the will of the majority---in Madison's day, the landless. Today, it is that clamorous "faction"---the majority, or the public---who wish to unseat the minority----or those private hands that have control not just over 94% of health care markets and the system as a whole, but even the individual, medical decisions about what kind of care is necessary and will be covered:

if elections were open to all classes of people, the property of the landed proprietors would be insecure...If these observations be just, our government ought to secure the permanent interests of the country against innovation. Landholders ought to have a share in the government, to support these invaluable interests, and to balance and check the other. They ought to be so constituted as to protect the minority of the opulent against the majority. The senate, therefore, ought to be this body; and to answer these purposes, they ought to have permanency and stability---James Madison in "Notes of the Secret Debates of the Federal Convention of 1787, Taken by the Late Hon Robert Yates, Chief Justice of the State of New York, and One of the Delegates from That State to the Said Convention."

Also consider Madison's political philosophy and system here:

Complaints are everywhere heard from our most considerate and virtuous citizens, equally the friends of public and private faith, and of public and personal liberty, that our governments are too unstable, that the public good is disregarded in the conflicts of rival parties, and that measures are too often decided, not according to the rules of justice and the rights of the minor party, but by the superior force of an interested and overbearing majority----James Madison, Federalist Paper #10.

Unlike the agrarian revolts springing up in America and Britain to which Madison was responding, a public health care competitor is in no way seeking to create "unstable" governments or to "disregard" "the public good" by "the superior force" "of an interested and overbearing majority." In fact, as many already know, it seeking to achieve----and would achieve----the opposite: stability with absolute regard for the public good. It's still early to determine whether supporters of the public option will be "the superior force" in the end, but we do know they are an "overbearing majority."

And the insurance companies are well-aware of this majoritarian support for health care reform, sharing Madison's anxiety over a well-organized majority "faction," and have begun financing and organizing faux populist protests against reform-minded members of Congress through groups such as FreedomWorks, Conservatives for Patients' Rights, Americans for Prosperity, and conservative media. This is their attempt to appear as that populist, "overbearing majority" of Madison's nightmares. Once again, The Daily Show has the most trenchant analysis of this process on the airwaves:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Master Rebators - The Crank Cycle
http://www.thedailyshow.com/
Daily Show Full Episodes Political Humor Spinal Tap Performance

Although Stewart's talking about the "Cash for Clunkers" program, the tactic or process----the Crank Cycle, if you will----is the same. (See the fantastic intro to this hilarious segment here).

So once again, if the Democrats don't pass substantial reform (i.e. a public option to help de-consolidate health insurance markets), we should know the structural and institutional reasons why. Nonetheless, with the power they enjoy right now in the Congress, and that ever-so-frightful-majoritarian support for a public (competitive) option behind them, there should be ABSOLUTELY no excuses this time! We wouldn't want to see a 21st Century Shay's Rebellion done health-care-reform style would we?